CHAPTER FOURTY-SEVEN DRUG THERAPY Flashcards

1
Q

how can drugs pass the blood brain barrier

A

be lipid soluble

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2
Q

what is myasthenia gravis

A

weakness or rapid fatigue of muscles
-autoimmune neuromuscular disorder
-shown in face expression, swallowing, weakness of eye muscles

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3
Q

treatment for myasthenia gravis

A

cholinergic drugs/acetylcholinesterase inhibitors

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4
Q

what kind of drug is neostigmine

A

acetylcholinesterase inhibitor
-reverses action of nondepolarizing neuromuscular blocking agents
-administered intravenously
-treats myasthenia gravis

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5
Q

adverse effects of acetylcholinesterase inhibitors and treatments for them

A

cardiovascular and respiratory issues
-nervous system effects (convulsions, dizziness)
- cant be used if hypersensitive, have lung disease, heart disease or benign prostatic hypertrophy
-can give atropine to decreases effects and give with food if given orally
-can give pyridostigmine to increase Ach

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6
Q

therapeutic effects of acetylcholinesterase inhibitors

A

-increase muscle strength
-decrease difficulty swallowing, speaking, and ptosis

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7
Q

what does cholinergic crisis look like

A

extreme weakness
SLUDGE
-salivation, lacrimation, urine incontinence, diarrhea, GI upset, Emesis
Atropine is the antidote, acts on heart, smooth muscle and glands
other treatments: decontamination, activated charcoal, hydration

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8
Q

characteristics of overstimulation of PNS

A

BAGPUDDLES
-bronchoconstriction+
-apnea
-gray vision
-pupil constriction
-increased urination
-diaphoresis
-deification
-lachrymation
-emesis
-seizures

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9
Q

what is Alzheimer’s disease

A

memory loss and loss of intellectual abilities
-most common form of dementia
-deficiency in cholinergic function
-treatment: cholinesterase inhibitors

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10
Q

what kind of drug is donepezil

A

cholinesterase inhibitor
- inhibits Ache
-oral administration, peak is 3-4 hours
-normally used with memantine, discontinue if no improvement

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11
Q

causes of urinary retention

A

spastic: contractions with low volume
-renal or spinal damage
-flaccid: large fluid volume but decreased pressure
-Diabetes, enlarged prostate, pregnancy, parkinsons, ms, surgery
treatment: cholinergic agonist

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12
Q

what kind of drug is memantine

A

NMDA N-methyl-aspartate receptor antagonist
-absorbed well orally
-blocks the glutamate receptor
contraindications: hypersensitivity and renal failure
-normally used with donepezil, discontinue if no improvement

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13
Q

what kind of drug is bethanechol chloride

A

-well absorbed in GI, not sure of metabolism/excretion, does cross placenta
-increases muscle tone in GI and Urinary system
-used for bladder retention

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